Everyone who is eligible and has the resources should take advantage of a health savings account (HSA). Why? They offer triple tax benefits: an up-front deduction for contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses. In fact, all else (e.g. employer matching) being equal, HSAs are not only the best type of account to pay for health-related expenses, but there is a legitimate argument that they are even the best type of retirement account. Thankfully, legislators like them too, and starting January 1st, 2026, 3 new rules resulting from the OBBBA legislation will make them more useful to even more people. Here’s what is changing:
1. Bronze and Catastrophic Health Insurance Plans Treated as HDHPs (Making them HSA-Compatible)
“Bronze” and “catastrophic” health insurance plans (those plans typically with higher deductibles and lower premiums than “silver” plans) available through an ACA exchange will be considered HSA-compatible, regardless of whether the plans satisfy the general definition of a high deductible health plan (HDHP). This means that those enrolled in bronze and catastrophic plans will be able contribute to HSAs, which they typically were not able to do previously.
Additionally, bronze and catastrophic plans do not have to be purchased through an ACA exchange to qualify for HSA compatibility. Both changes should result in more people being eligible to contribute to an HSA.
2. Direct Primary Care Service Arrangements Are Eligible for HSA Payments
An otherwise HSA-eligible individual enrolled in certain direct primary care service arrangements (DPCSA) may contribute to an HSA. In addition, eligible individuals may use their HSA funds tax-free to pay periodic DPCSA fees.
Previously, DPCSAs were ineligible for payments from an HSA under IRS rules. DPPCAs, which aren’t billed through insurance, also won’t block eligibility for HSA contributions, with some restrictions.
3. Telehealth and Remote Care Services Favorable Treatment is Restored
Telehealth and remote care services were previously temporarily approved as qualified medical expenses that could be paid for with HSAs prior to a patient’s deductible being met, through COVID-era legislation. Technically, that eligibility had expired. That eligibility has now been restored permanently in to the future and retroactively back to Jan. 1, 2025.
The 3 new HSA rule changes for 2026 are described in more detail, along with an exhaustive FAQ, in a document released by the IRS. I’d strongly recommend digging in to the specifics if you think they could be applicable to your situation.
How to Get the Most Out of your HSA in 2026 and Beyond
In general, anyone who is eligible for HSA contributions would be well-served to follow these tips to get the most out of their HSA in 2026 and beyond:
- Contribute as much as you can to your HSA: following the maximum HSA contribution guidelines (and in making sure to receive the full amount of an employer’s matching HSA funds). The HSA contribution deadline is the same as the tax deadline for a given year, giving you a few extra months to contribute. In 2025, the maximum contribution amount is $4,300 per individual, $8,550 per family. That increases to $4,400 and $8,750 in 2026.
- Become familiar with the qualified medical expenses list: the list of things you can purchase with HSA funds is ever-expanding (and sometimes surprising).
- Time your contributions wisely: some employers will allow you to make larger contributions towards the end of the year to catch up, and some employers may even allow you to front-load your HSA contributions at the beginning of the year – giving more time for investment growth.
- Think outside the employer box: you can contribute to an HSA outside of an employer (if you are eligible to contribute).
- Upgrade your HSA: you own your HSAs. Opening a new HSA or transferring funds from an existing HSA to another HSA is easy to do. Each year, I update a list of the best HSA accounts. If your current employer’s HSA is not the best, you can transfer funds from it to your own separate HSA, and can even do so while you are still employed and using it. There are no restrictions against having multiple HSA accounts, so you can create a new one at any time.
- Boost your HSA balance: pair an HSA with an FSA, when possible, to preserve and grow your HSA funds as much as you can.